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With reference to the report by Tanne, the author quotes Dr Richard
Howard on the subject of the treatment of pain in children as saying,
"There is a substantive gap between what we know and what we do." (1)
What we know is that babies admitted to the neonatal unit undergo
numerous painful procedures, more than 50% being heel prick blood samples.
(2) We also know that a Cochrane review found sucrose to be a safe and
effective measure for reducing procedural pain in neonates. (3)
Despite this knowledge of several years, neonates are still being
undertreated for pain in the UK. In a telephone survey carried out by our
unit in early December 2003 of 50 neonatal units in England and Wales, we
found that only 15 units (30%) had unit guidelines for the use of sucrose
for procedural pain in neonates. A further 15 units were in various stages
of considering implementation of such a policy, with 20 units seemingly
making no headway, despite the evidence. (The current guidelines for
analgesia for procedural pain in use on our unit may be viewed at www.wn3.
org.uk.)
We intend to re-visit this issue in the future, when we hope that the
gap between what we know and what we do may have narrowed, to the benefit
of our patients.
References:
1) Tanne JH. Children are often undertreated for pain. BMJ
2003;327:1185 (22 November)
2) Barker DP, Rutter N. Exposure to invasive procedures in neonatal
intensive care unit admissions. Archives of Disease in Childhood Fetal
& Neonatal Edition. 72(1):F47-8 (1995 Jan)
3) Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn
infants undergoing painful procedures. The Cochrane Library, Issue 3, 2002
this is in response to the article on pain by Tanne. i really could
not make out what the procedure was and why it would need pain relief!do
enlighten all of us who have seen the picture and wondered about it
We were intrigued by the photograph accompanying Hopkins Tanne
article on pain management in children. As paediatric trainees, we were
unable to establish what procedure was being undertaken. In addition, we
are concerned at the additional discomfort to the child from having nasal
cannulae oxygen tubing placed over the eyes. Finally, we also noted the
procedure is being performed without wearing gloves.
Neonates are often undertreated for pain
With reference to the report by Tanne, the author quotes Dr Richard
Howard on the subject of the treatment of pain in children as saying,
"There is a substantive gap between what we know and what we do." (1)
What we know is that babies admitted to the neonatal unit undergo
numerous painful procedures, more than 50% being heel prick blood samples.
(2) We also know that a Cochrane review found sucrose to be a safe and
effective measure for reducing procedural pain in neonates. (3)
Despite this knowledge of several years, neonates are still being
undertreated for pain in the UK. In a telephone survey carried out by our
unit in early December 2003 of 50 neonatal units in England and Wales, we
found that only 15 units (30%) had unit guidelines for the use of sucrose
for procedural pain in neonates. A further 15 units were in various stages
of considering implementation of such a policy, with 20 units seemingly
making no headway, despite the evidence. (The current guidelines for
analgesia for procedural pain in use on our unit may be viewed at www.wn3.
org.uk.)
We intend to re-visit this issue in the future, when we hope that the
gap between what we know and what we do may have narrowed, to the benefit
of our patients.
References:
1) Tanne JH. Children are often undertreated for pain. BMJ
2003;327:1185 (22 November)
2) Barker DP, Rutter N. Exposure to invasive procedures in neonatal
intensive care unit admissions. Archives of Disease in Childhood Fetal
& Neonatal Edition. 72(1):F47-8 (1995 Jan)
3) Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn
infants undergoing painful procedures. The Cochrane Library, Issue 3, 2002
Competing interests:
None declared
Competing interests: No competing interests